{{ 'SHOW_CART' | translate }} >

{{total | currency:"$"}}

{{::eventInfo.eventName}}

{{::eventInfo.when}}
{{::eventInfo.where}}

{{::eventInfo.description}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-SECONDARY-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'FIRST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'LAST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'BIRTH-DATE' | translate}}

{{ 'IDENT.RACE_AGE_BETWEEN' | translate:regOptionAgeTranslate }}

{{ 'IDENT.SERIES_RACE_AGE_ERROR' | translate }}

{{ 'REQUIRED' | translate }}

{{'REQUIRED_DATE_FORMAT' | translate:'{format: eventInfo.displayDateFormat}' }}

{{ 'GENDER' | translate}}

{{ 'REG-OPTION-GENDER-ERROR' | translate}}

{{ 'PRIMARY-PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'EMAIL' | translate}}

{{ 'EMAIL-CONFIRM' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'SAME-EMAIL' | translate}}

{{ 'PARTICIPANT-CONDITION' | translate}}

In consideration of your accepting my entry and of being permitted to participate in the 2017 RaceTrac Run for Research 5k (“the Race”), the undersigned, for himself, his personal representatives and heirs, and where applicable, as parent, guardian or managing or possessory conservator of the minor child or children named below, releases, discharges and agrees to defend, indemnify and hold harmless the Race, RaceTrac, their directors, representatives and volunteers, Event Southwest, its employees, representatives and volunteers, Apple Event Services, its employees, representatives and volunteers, and any official sponsor of the Race (hereinafter collectively referred to as “Released Parties”) from any and all liability, rights, claims, demands, and or causes of actions which the undersigned and minor child participant(s) have or may have arising out of or in any way relating to the Race. THIS RELEASE AND OBLIGATION TO DEFEND, INDEMNIFY AND HOLD HARMLESS SHALL BE ENFORCEABLE WITHOUT REGARD TO THE ACTUAL OR ALLEGED NEGLIGENCE OR OTHER FAULT OF THE RELEASED PARTIES, IT BEING THE EXPRESSED INTENTION OF THE UNDERSIGNED TO INDEMNIFY AND RELEASE THE RELEASED PARTIES FOR THE CONSEQUENCES OF THEIR OWN ACTUAL OR ALLEGED NEGLIGENCE OR OTHER FAULT.
I grant to RaceTrac the right to take photographs of me and my family in connection with RaceTrac’s Run for Research. I authorize RaceTrac, its assigns and transferees to copyright, use and publish the same in print and/or electronically.I agree that RaceTrac may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

{{ 'MUST-AGREE' | translate}}

{{ 'COUNTRY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET_2' | translate}}

{{ 'POSTAL-CODE' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}} {{ 'VALID-ZIP' | translate}}

{{ 'CITY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STATE/REGION' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'NAME' | translate}}

{{ 'REQUIRED' | translate }}

{{ 'RELATIONSHIP' | translate}}

{{ 'PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'CONTACT-CANNOT-BE-EVENT-P' | translate}}

Leave this blank if you are not a RaceTrac employee...
{{'VALUE_SHORTER_THAN' | translate:'{char: "50"}' }}
Mark all that apply

{{ 'REQUIRED' | translate }}

{{ 'REQUIRED' | translate }}

{{crowdrise.elementNames.crowdriseLabel}}

{{"CROWDRISE_YES" | translate}}

{{ 'CROWDRISE-TEAM-EXIST' | translate}}

{{ !gigyaLoaded() ? 'GET-ATHLETE-UPDATE-MOBILE' : 'GET-ATHLETE-UPDATE' | translate}}

{{ !gigyaLoaded() ? 'MOBILE-DELIVER' : 'FACEBOOK-DELIVER' | translate}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'CORRECT_ERRORS_FOR_ENTRY' | translate }}

{{ 'COMPLETE_REGISTRATION_FOR_ENTRIES' | translate}}

{{entry.name | translateIf:entry.translate}}

{{ 'EDIT' | translate }} (errors)

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
{{ 'SUBTOTAL' | translate}} : {{cart.subtotal | currency:"$":currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$":currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.fee | currency:"$":currency.decimal}}
{{!cart.hasLottery ? ('TOTAL'|translate) : ('TOTAL_CHARGE_AT_CHECKOUT'|translate)}} : {{cart.total | currency:"$": currency.decimal}}

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
{{ 'SUBTOTAL' | translate}} : {{cart.subtotalLottery | currency:"$": currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$": currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.lotteryFee | currency:"$": currency.decimal}}
{{ 'TOTAL_CHARGE_IF_SELECTED' | translate}} : {{cart.lotteryTotal | currency:"$": currency.decimal}}
{{ 'IF_SELECTED_CHECKOUT' | translate:cart}}

{{ 'PAYMENT-ERROR' | translate}}

{{paymentErrors.message}}

  • {{error}}
{{ 'NO-PAYMENT-REQUIRED' | translate }}

{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
{{ 'POSTAL-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'PAYMENT-INFORMATION-MESSAGE' | translate }}



{{crowdriseTeam.entryName}} Charity Event Fundraising on Crowdrise

{{crowdriseTeam.entryName}}: {{crowdriseTeam.msg}} (Crowdrise error)

The internet browser you are using to access this registration form is not supported. Please upgrade your browser or register on your mobile device.
Scan this QR Code with your mobile device to load the mobile registration form.
Event registration link